I remember hearing an important piece of advice: “If you are passionate about something, you will make time for it in medical school.” This advice, however, was soon countered by a snarky follow-up: “It is not that you did not have time for it; you did not make time for it.”
The pressure and anxiety surrounding Step 1 is one of the main reasons cited by the USMLE to justify its adoption of a pass-fail grading system. However, many medical students are met with more trepidation about their future as this major anticipated change in Step 1 takes effect.
On July 27, 2020, I began the first day of orientation week at the Medical College of Georgia (MCG). After over four years of living in Atlanta, the initial 25-minute drive from home to school threw me back to my high school days of having to wake up at six o’clock in the morning. The entire first week was a bit of a blur, and I do not remember much aside from getting my stethoscope and helping draft a class oath.
Presenteeism does not simply exist for seasoned providers; it seeps down the medical training pipeline and perhaps poses the greatest threat to trainees at the start of their careers. The fear of missing out as the “beginner on the team” can be paralyzing when there is so much important knowledge beyond us. Such pressure persists longitudinally, too, as trainees at every level fear that taking time off will appear as a lack of dedication to clinical education or will result in lower performance evaluations.
Our illness narrative, the COVID narrative, is about so much more than regaining health (though I acknowledge that for those afflicted by the disease, overcoming the debilitating circumstances may be more than can even be hoped for). Returning to Frank’s ideas, our narrative is about rediscovering the voice that was stolen by forces beyond our control.
On the first day of anatomy, we were reminded that this course was a once-in-a-lifetime experience and that we were privileged to be experiencing it. For those of us first-year medical students who might not pursue surgery nor experience physically interacting with and entering the human body again outside of surgical clerkships, the professors said this would be an intense time. We would peer into the spaces and structures that — on some level — make up every human being.
In the golden glow of a fall day, 104 first-year medical students parade out of the medical center carrying boxes of bones to aide our anatomy lab studies. The crates look suspiciously like instrument cases, perhaps the size of an alto saxophone, and it feels absurd to march back to our houses a la The Music Man, knowing all the while that we are bringing real live (well, dead) human skeletons into our living rooms, kitchens and coat closets.
Over the next four weeks, I will share a series of essays with you in which I tell some of those stories. This writing results from the work of a summer, supported by a summer research fellowship in Medical Humanities & Bioethics at the University of Rochester School of Medicine and Dentistry, in which I interviewed nine first-year medical students, two third-year medical students, eight anatomy and medical humanities professors, two Anatomical Gift Program staff, three palliative care clinicians, two preregistered donors and one donor’s family member.
Regardless, with this data in mind, it is important for students in medical education to understand that we are entering the profession at a time where the reputation that precedes us is not ideal. This also means that the capacity to alter this perception is dependent on the way we practice upon entering the workforce.
We have seen our classmates’ faces, memorized each other’s hometowns and politely chuckled at every “fun fact” introduction despite having heard it countless times. Some of us have admitted to writing down random facts about others as we hear them, hoping to review them later and somehow kindle more profound relationships than the pandemic naturally allows. We virtually contact each other later with a random sentiment trying to relate to someone’s favorite sports team or vacation place.
Thank you for your contributions and your readership over the past year. It has certainly been a difficult one, and we are exceedingly grateful that you all used in-Training as a platform to share your reflections, opinions, and solutions. Run by medical students and for medical students, your ongoing support is what makes us a premier online peer-reviewed publication. We look forward to seeing your contributions in 2021, and we’re excited to see where the year takes us (hopefully some place better!).
Improvement is at the core of who physicians are. If we do not strive to be better versions of ourselves, then we are doing a disservice to our patients who deserve good care. However, in order for medical students and physicians to pursue such a lifelong career of learning, we need to decidedly put aside this idea that we can ever be “perfect.” Medical professionals can never be, as Merriam-Webster defines the word, “entirely without fault or defect.”